-----BEGIN PRIVACY-ENHANCED MESSAGE----- Proc-Type: 2001,MIC-CLEAR Originator-Name: webmaster@www.sec.gov Originator-Key-Asymmetric: MFgwCgYEVQgBAQICAf8DSgAwRwJAW2sNKK9AVtBzYZmr6aGjlWyK3XmZv3dTINen TWSM7vrzLADbmYQaionwg5sDW3P6oaM5D3tdezXMm7z1T+B+twIDAQAB MIC-Info: RSA-MD5,RSA, JiHDi92srkbu7blpH0M0dbgwgjQJ+TF4mRERPKXKPsSWlSVpbXK9rtVDFEQ1bvzS FQJN41ojAQxgLmMW1kvFwA== 0001179110-04-023396.txt : 20041216 0001179110-04-023396.hdr.sgml : 20041216 20041216153126 ACCESSION NUMBER: 0001179110-04-023396 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20041215 FILED AS OF DATE: 20041216 DATE AS OF CHANGE: 20041216 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: MERIT MEDICAL SYSTEMS INC CENTRAL INDEX KEY: 0000856982 STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841] IRS NUMBER: 870447695 STATE OF INCORPORATION: UT FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 1600 WEST MERIT PARK WAY CITY: SOUTH JORDAN STATE: UT ZIP: 84095 BUSINESS PHONE: 8012531600 MAIL ADDRESS: STREET 1: 1600 WEST MERIT PARKWAY CITY: SOUTH JORDAN STATE: UT ZIP: 84095 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Stephens Martin R CENTRAL INDEX KEY: 0001310727 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-18592 FILM NUMBER: 041208107 BUSINESS ADDRESS: BUSINESS PHONE: 801 208-4141 MAIL ADDRESS: STREET 1: 1600 W MERIT PARKWAY CITY: SOUTH JORDAN STATE: UT ZIP: 84095 4 1 edgar.xml FORM 4 - X0202 4 2004-12-15 0 0000856982 MERIT MEDICAL SYSTEMS INC MMSI 0001310727 Stephens Martin R 1600 W. MERIT PARKWAY SOUTH JORDAN UT 84095 0 1 0 0 VP of Sales Common Stock, No Par Value 2004-12-15 4 P 0 2190 14.71 A 2190 D Common Stock, No Par Value 2004-12-15 4 P 0 400 14.72 A 2590 D Common Stock, No Par Value 2004-12-15 4 P 0 100 14.73 A 2690 D Common Stock, No Par Value 2004-12-15 4 P 0 4710 14.75 A 7400 D Common Stock, No Par Value 293 I By 401 (k) Plan Non-qualified stock options (right to buy) 14.48 2005-07-14 2009-07-14 Common Stock 5000 5000 D Represents shares held by the Merit Medical Systems, Inc. 401(k) Profit Sharing Plan and Trust for the Benefit of the reporting person as of 12/06/04. The option vests in equal annual installments of 1,000 shares, commencing on July 14, 2005 and continuing through July 14, 2009. Martin R. Stephens 2004-12-16 -----END PRIVACY-ENHANCED MESSAGE-----